Workplace Survey

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Documents and Forms

Document Name Document Type
Form 0920-22SF Workplace Survey Form and Instruction
Form 0920-22SF Workplace Survey Form and Instruction
0920-22SF Workplace Survey Att.3—Workplace Survey.docx Form and Instruction
0920-22SF Workplace Survey Att.3—Workplace Survey.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Workplace Survey	Agency IC Tracking Number:	0920-22SF

Is this a Common Form? Yes		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-22SF	Workplace Survey	Att.3—Workplace Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 8,600	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	8,600	8,600
Annual IC Time Burden (Hours)	2,150	2,150
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.